In 1997, the first Enterovirus 71 (EV71) epidemic was reported in Malaysia. EV71 is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children.

Since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2-3 years for reasons that remain unclear. Researchers hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence).

The initial epidemic of predominantly ‘EV-A71’ was reported in California in 1969. The high prevalence of HFMD in the Asia-pacific region and elsewhere around the world represents a significant morbidity in this age group.